After an ovarian cancer diagnosis, the Gynecologic Oncologist will present ovarian cancer treatment options. Which treatment is right for each patient depends on multiple factors and women may undergo more than one treatment at a time for the best possible outcomes?
Ovarian Cancer Treatment Options
With continued research, Gynecologic Oncologists gain an even better understanding of ovarian cancer and treatments evolve to reflect this new knowledge. At the present time, ovarian cancer treatment options include:
- Radiation therapy
- Hormone therapy
- Targeted therapy
Ovarian Cancer Surgery
Surgical intervention is the most common ovarian cancer treatment. The goal of surgery depends on the specific type of ovarian cancer:
- Epithelial Ovarian Cancer: Treatment includes exploratory surgery to stage the disease and “debulking” to remove as much cancerous tissue as possible. Debulking is considered a success if no tumors larger than 1 cm are left after surgery. During debulking, the ovaries and uterus are often removed, triggering menopause in women who are not yet menopausal. Depending on how far the cancer has spread, portions of the spleen, colon, small intestine, bladder, liver, and/or pancreas may also be removed.
- Germ Cell Ovarian Cancer: Treatment often requires a hysterectomy and removal of the ovaries and fallopian tubes. If the woman hopes to have children and only one ovary and fallopian tube are cancerous, it may be possible to save the cancer-free ovary and uterus. This possibility would be further discussed with you and the Gynecologic Oncologist.
- Stromal Tumors: As stromal tumors are often restricted to a single ovary, it may be possible to remove only the diseased ovary and associated fallopian tube. If the cancer has spread to both ovaries, the fallopian tubes and uterus may be removed, and stromal tumors also require debulking.
Chemotherapy and Ovarian Cancer Treatment
Chemotherapy uses a wide range of medication to kill rapidly growing cancer cells. Two or more drugs are usually administered over the course of several weeks. The goal is to either shrink tumors before surgical removal or to force any remaining cancer after staging and debulking into remission (a period of dormancy where no cancer symptoms can be detected).
As chemotherapy is designed to kill fast-growing cells, treatment also kills cells which normally grow at a rapid rate. This produces several side effects which include:
- Easy bleeding or bruising
- Hair loss
- Hand and foot rashes
- Increased risk of infection
- Loss of appetite
- Mouth sores
- Nausea and vomiting
- Possible kidney damage
- Peripheral nerve damage
Certain genetic mutations increase the risk of developing ovarian cancer. If you test positive for these genetic markers, the ovarian cancer treatment options include targeted therapy, which attacks mutated cells directly with less damage to normal cells in comparison to standard chemotherapy. Targeted therapy alters how cancer cells grow, repair themselves, and interact with normal cells.
Examples of targeted therapy include the following medications:
- Bevacizumab: prevents tumors from forming the blood vessels needed to nourish the tumor.
- PARP Inhibitors: prevent tumor cells with BRCA mutations from repairing damaged DNA which results in cancer cell death.
Radiation therapy uses high energy x-rays to kill cancer cells. Radiation is rarely used as a primary ovarian cancer treatment and is usually used to treat areas where the cancer has spread.
Hormone therapy alters the levels of estrogen and progesterone in a women’s body to interfere with the growth and development of cancer cells. As an ovarian cancer treatment, hormone therapy can be used to treat stromal tumors.
Immunotherapy uses drugs and other substances to strength the body’s immune system, helping the body identify and destroy cancer cells. Vaccine therapy, a form of immunotherapy, is currently under study as an advanced ovarian cancer treatment.